1
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Doherty TM, Ecarnot F, Gaillat J, Privor-Dumm L. Nonstructural barriers to adult vaccination. Hum Vaccin Immunother 2024; 20:2334475. [PMID: 38629573 PMCID: PMC11028002 DOI: 10.1080/21645515.2024.2334475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024] Open
Abstract
Adult vaccination coverage remains low, despite vaccine recommendations, improved access, and reimbursement. Low vaccination coverage and an aging population at higher risk from vaccine-preventable diseases lead to preventable disability and deaths, straining healthcare systems. An Advisory Board meeting was, therefore, held to identify non-structural barriers to adult vaccination and discuss potential solutions to increase uptake. Many non-structural factors can influence vaccine uptake, such as heterogeneity in the population, (fear of) vaccine shortages, incentives, or mandates for vaccination, understanding of disease burden and personal risks, time and opportunity for healthcare providers (HCPs) to discuss and deliver vaccines during general practice or hospital visits, trust in the health system, and education. To address these barriers, push-pull mechanisms are required: to pull patients in for vaccination and to push HCP performance on vaccination delivery. For patients, the focus should be on lifelong prevention and quality of life benefits: personal conversations are needed to increase confidence and knowledge about vaccination, and credible communication is required to build trust in health services and normalize vaccination. For providers, quality measurements are required to prioritize vaccination and ensure opportunities to check vaccination status, discuss and deliver vaccines are not missed. Financial and quality-based incentives may help increase uptake.
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Affiliation(s)
| | | | | | - Lois Privor-Dumm
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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2
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Janssen C, Mosnier A, Gavazzi G, Combadière B, Crépey P, Gaillat J, Launay O, Botelho-Nevers E. Coadministration of seasonal influenza and COVID-19 vaccines: A systematic review of clinical studies. Hum Vaccin Immunother 2022; 18:2131166. [PMID: 36256633 DOI: 10.1080/21645515.2022.2131166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The lifting of non-pharmaceutical measures preventing transmission of SARS-CoV-2 (and other viruses, including influenza viruses) raises concerns about healthcare resources and fears of an increased number of cases of influenza and COVID-19. For the 2021-2022 influenza season, the WHO and >20 European countries promoted coadministration of influenza and COVID-19 vaccines. Recently, the French Health Authority recommended coupling the COVID-19 vaccination with the 2022-2023 influenza vaccination campaign for healthcare professionals and people at risk of severe COVID-19. The present systematic review examines published data on the safety, immunogenicity, efficacy/effectiveness, and acceptability/acceptance of coadministration of influenza and COVID-19 vaccines. No safety concerns or immune interferences were found whatever the vaccines or the age of vaccinated subjects (65- or 65+). No efficacy/effectiveness data were available. The results should reassure vaccinees and vaccinators in case of coadministration and increase vaccine coverage. Healthcare systems promoting coupled campaigns must provide the necessary means for successful coadministration.
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Affiliation(s)
- Cécile Janssen
- Service de Maladies Infectieuses, Centre Hospitalier Annecy Genevois, Annecy, France
| | | | - Gaëtan Gavazzi
- Service Universitaire de Gériatrie Clinique, CHU Grenoble Alpes, Grenoble, France.,Laboratoire T-Raig TIMC-IMAG CNRS 5525, Université Grenoble-Alpes, Grenoble, France
| | - Behazine Combadière
- Center for Immunology and Infectious Diseases, Sorbonne University, Inserm U1135, Paris, France
| | - Pascal Crépey
- Ecole des hautes études en santé publique, CNRS, Université de Rennes, ARENES - UMR 6051, Recherche sur les services et le management en santé - Inserm U 1309, Rennes, France
| | - Jacques Gaillat
- Service de Maladies Infectieuses, Centre Hospitalier Annecy Genevois, Annecy, France
| | - Odile Launay
- CIC 14117 Cochin-Pasteur, Université Paris Cité, Inserm, F CRIN-I REIVAC, Paris, France
| | - Elisabeth Botelho-Nevers
- Service d'Infectiologie, Hôpital Nord-CHU Saint Etienne, Saint-Etienne, France.,CIRI - Team GIMAP, Univ. Lyon, Université Jean Monnet, Université Claude Bernard Lyon 1, Inserm, U1111, Saint-Etienne, France
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3
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Boussat B, Cazzorla F, Le Marechal M, Pavese P, Mounayar AL, Sellier E, Gaillat J, Camara B, Degano B, Maillet M, Courtois X, Bouisse M, Seigneurin A, François P. Incidence of Avoidable 30-Day Readmissions Following Hospitalization for Community-Acquired Pneumonia in France. JAMA Netw Open 2022; 5:e226574. [PMID: 35394509 PMCID: PMC8994128 DOI: 10.1001/jamanetworkopen.2022.6574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Rates of 30-day readmissions following hospitalization for pneumonia are used to publicly report on hospital performance and to set financial penalties for the worst-performing hospitals. However, the rate of avoidable readmission following hospitalization for pneumonia is undefined. OBJECTIVE To assess how often 30-day readmissions following hospitalization for community-acquired pneumonia (CAP) are avoidable. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed the results of an independent review of readmissions following hospitalization for CAP within 30 days among patients discharged from 2 large hospitals in France in 2014. Structured clinical records including clinical information (ie, baseline characteristics, physical examination, laboratory findings, x-ray or computed tomography scan findings, discharge plan, and treatments) for both index and readmission stays were independently reviewed by 4 certified board physicians. All consecutive adult patients hospitalized in 2014 with a diagnosis of CAP in our 2 eligible hospitals were eligible. All analyses presented were performed in March 2021. MAIN OUTCOMES AND MEASURES Avoidable readmission within 30 days of discharge from index hospitalization. The likelihood that a readmission was avoidable was quantified using latent class analysis based on the independent reviews. A readmission was considered avoidable if Bayes posterior probability exceeded 50%. RESULTS The total analytical sample consisted of 1150 index hospital stays with a diagnosis of CAP, which included 651 (56.6%) male patients. The median (IQR) age for all patients was 77.8 (IQR, 62.7-86.4) years. Out of the 1150 index hospital stays, 98 patients (8.5%) died in hospital, and 108 (9.4%) unplanned readmissions were found. Overall, 15 readmissions had a posterior probability of avoidability exceeding 0.50 (13.9% of the 108 unplanned readmissions; 95% CI, 8.0%-21.9%). The median (IQR) delay between the hospital discharge index and readmission was considerably shorter when readmission was deemed avoidable (4 [6-21] days vs 12 [2-18] days; P = .02). CONCLUSIONS AND RELEVANCE Only a small number of readmissions following hospitalization for CAP were deemed avoidable, comprising less than 10% of all readmissions. Shorter time interval between hospitalization discharge and readmission was associated with avoidability.
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Affiliation(s)
- Bastien Boussat
- Service d’épidémiologie et évaluation médicale, CHU Grenoble-Alpes, Grenoble, France
- Laboratoire TIMC-IMAG, UMR 5525 Joint Research Unit, Centre National de Recherche Scientifique, Université Grenoble-Alpes, France
- O’Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Fabiana Cazzorla
- Service d’épidémiologie et évaluation médicale, CHU Grenoble-Alpes, Grenoble, France
| | | | - Patricia Pavese
- Service des maladies infectieuses, CHU Grenoble-Alpes, Grenoble, France
| | | | - Elodie Sellier
- Service d’information médicale, CHU Grenoble-Alpes, Grenoble, France
| | - Jacques Gaillat
- Service d’information et d’évaluation médicale, Centre hospitalier Annecy-Genevois, Épagny-Metz-Tessy, France
| | - Boubou Camara
- Service de pneumologie, CHU Grenoble-Alpes, Grenoble, France
| | - Bruno Degano
- Service de pneumologie, CHU Grenoble-Alpes, Grenoble, France
| | - Mylène Maillet
- Service des maladies infectieuses, Centre hospitalier Annecy-Genevois, Épagny-Metz-Tessy, France
| | - Xavier Courtois
- Service d’information et d’évaluation médicale, Centre hospitalier Annecy-Genevois, Épagny-Metz-Tessy, France
| | - Magali Bouisse
- Service d’épidémiologie et évaluation médicale, CHU Grenoble-Alpes, Grenoble, France
| | - Arnaud Seigneurin
- Service d’épidémiologie et évaluation médicale, CHU Grenoble-Alpes, Grenoble, France
- Laboratoire TIMC-IMAG, UMR 5525 Joint Research Unit, Centre National de Recherche Scientifique, Université Grenoble-Alpes, France
| | - Patrice François
- Service d’épidémiologie et évaluation médicale, CHU Grenoble-Alpes, Grenoble, France
- Laboratoire TIMC-IMAG, UMR 5525 Joint Research Unit, Centre National de Recherche Scientifique, Université Grenoble-Alpes, France
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4
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Lemaitre M, Fouad F, Carrat F, Crépey P, Gaillat J, Gavazzi G, Launay O, Mosnier A, Levant MC, Uhart M. Estimating the burden of influenza-related and associated hospitalizations and deaths in France: An eight-season data study, 2010-2018. Influenza Other Respir Viruses 2022; 16:717-725. [PMID: 35014194 PMCID: PMC9178052 DOI: 10.1111/irv.12962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background In France, each year, influenza viruses are responsible for seasonal epidemics leading to 2–6 million cases. Influenza can cause severe disease that may lead to hospitalization or death. As severe disease may be due to the virus itself or to disease complications, estimating the burden of severe influenza is complex. The present study aimed at estimating the epidemiological and economic burden of severe influenza in France during eight consecutive influenza seasons (2010–2018). Methods Influenza‐related hospitalization and mortality data and patient characteristics were taken from the French hospital information database, PMSI. An ecological approach using cyclic regression models integrating the incidence of influenza syndrome from the Sentinelles network supplemented the PMSI data analysis in estimating excess hospitalization and mortality (CépiDc—2010–2015) and medical costs. Results Each season, the average number of influenza‐related hospitalizations was 18,979 (range: 8627–44,024), with an average length of stay of 8 days. The average number of respiratory hospitalizations indirectly related with influenza (i.e., influenza associated) was 31,490 (95% confidence interval [CI]: 24,542–39,012), with an average cost of €141 million (range: 54–217); 70% of these hospitalizations and 77% of their costs concerned individuals ≥65 years of age (65+). More than 90% of excess mortality was in 65+ subjects. Conclusions The combination of two complementary approaches allowed estimation of both influenza‐related and associated hospitalizations and deaths and their burden in France, showing the substantial impact of complications. The present study highlighted the major public health burden of influenza and its severe complications, especially in 65+ subjects.
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Affiliation(s)
| | | | - Fabrice Carrat
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (Inserm), Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Unité de Santé Publique, Paris, France
| | - Pascal Crépey
- Université de Rennes, EHESP, REPERES-EA 7449, Rennes, France
| | | | - Gaëtan Gavazzi
- CHU Grenoble Alpes, Clinique Universitaire de Gériatrie, Pavillon Elisée-Chatin, and GREPI EA 7408, Université Grenoble Alpes, Grenoble, France
| | - Odile Launay
- Faculté de Médecine Paris Descartes, Université de Paris, Paris, France.,Inserm, CIC 1417, F-CRIN I-REIVAC, Assistance Publique-Hôpitaux de Paris, CIC Cochin-Pasteur, Paris, France
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5
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Blanc E, Chaize G, Fievez S, Féger C, Herquelot E, Vainchtock A, Timsit JF, Gaillat J. The impact of comorbidities and their stacking on short- and long-term prognosis of patients over 50 with community-acquired pneumonia. BMC Infect Dis 2021; 21:949. [PMID: 34521380 PMCID: PMC8442401 DOI: 10.1186/s12879-021-06669-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/28/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prognosis of patients hospitalized with community-acquired pneumonia (CAP) with regards to intensive care unit (ICU) admission, short- and long-term mortality is correlated with patient's comorbidities. For patients hospitalized for CAP, including P-CAP, we assessed the prognostic impact of comorbidities known as at-risk (AR) or high-risk (HR) of pneumococcal CAP (P-CAP), and of the number of combined comorbidities. METHODS Data on hospitalizations for CAP among the French 50+ population were extracted from the 2014 French Information Systems Medicalization Program (PMSI), an exhaustive national hospital discharge database maintained by the French Technical Agency of Information on Hospitalization (ATIH). Their admission diagnosis, comorbidities (nature, risk type and number), other characteristics, and their subsequent hospital stays within the year following their hospitalization for CAP were analyzed. Logistic regression models were used to assess the associations between ICU transfer, short- and 1-year in-hospital mortality and all covariates. RESULTS From 182,858 patients, 149,555 patients aged ≥ 50 years (nonagenarians 17.8%) were hospitalized for CAP in 2014, including 8270 with P-CAP. Overall, 33.8% and 90.5% had ≥ 1 HR and ≥ 1 AR comorbidity, respectively. Cardiac diseases were the most frequent AR comorbidity (all CAP: 77.4%). Transfer in ICU occurred for 5.4% of CAP patients and 19.4% for P-CAP. Short-term and 1-year in-hospital mortality rates were 10.9% and 23% of CAP patients, respectively, significantly lower for P-CAP patients: 9.2% and 19.8% (HR 0.88 [95% CI 0.84-0.93], p < .0001). Both terms of mortality increased mostly with age, and with the number of comorbidities and combination of AR and HR comorbidities, in addition of specific comorbidities. CONCLUSIONS Not only specific comorbidities, but also the number of combined comorbidities and the combination of AR and HR comorbidities may impact the outcome of hospitalized CAP and P-CAP patients.
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Affiliation(s)
| | | | | | - C Féger
- EMIBiotech, Paris, France
- ICUREsearch, Paris, France
| | | | | | - J F Timsit
- Medical and Infectious Diseases ICU, Bichat-Claude Bernard Hospital, APHP, Paris, France
- UMR 1137-IAME Team 5-DeSCID: Decision SCiences in Infectious Diseases Control and Care INSERM/University of Paris, Paris, France
| | - J Gaillat
- Infectious Diseases Department, Annecy-Genevois Hospital, Annecy, France.
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6
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Benadji A, Duval X, Danis K, Hoen B, Page B, Béraud G, Vernet-Garnier V, Strady C, Brieu N, Maulin L, Roy C, Ploy MC, Gaillat J, Varon E, Tubiana S. Relationship between serotypes, disease characteristics and 30-day mortality in adults with invasive pneumococcal disease. Infection 2021; 50:223-233. [PMID: 34468953 DOI: 10.1007/s15010-021-01688-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/20/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Invasive pneumococcal disease (IPD) is responsible for substantial mortality and morbidity worldwide. We aimed to identify host and bacterial factors associated with 30-day mortality in 18-year-old patients hospitalized with IPD in France from 2013 to 2015. METHODS This study analyzed data collected from consecutives IPD cases included in two parallel multi-center cohort studies: COMBAT study (280 patients with pneumococcal community-acquired bacterial meningitis) and SIIP study (491 patients with non-meningitis IPD). Factors associated with 30-day mortality were identified using logistic regression. RESULTS Among the 771 enrolled patients (median age 66 years, IQR [52.0-79.7]), 592/767 (77.2%) had at least one chronic disease. Patients with meningitis were younger (60.2 vs 70.9 years; p < 0.001) and had fewer chronic diseases than those with non-meningitis IPD (73.3% vs 79.4%; p = 0.05). Non-vaccine serotypes were more frequent in meningitis patients than in those with other IPD (36.1% vs 23.1%; p < 0.001). The overall 30-day mortality was 16.7% and patients with concurrent meningitis and extra-cerebral IPD had the highest 30-day mortality rate (26.5%). On multivariate analyses, older age, history of malignant solid tumor, meningeal IPD and serotypes previously identified with high mortality potential were independently associated with 30-day mortality. Of the serotypes with high mortality potential, 80% were included in licensed (PCV13 or PPV23) vaccines. CONCLUSION We observed an effect of both host factors and pneumococcal serotypes on 30-day mortality in IPD. This highlights the need for a focused strategy to vaccinate at-risk patients. CLINICAL TRIAL ClinicalTrial. Gov identification number: NCT01730690.
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Affiliation(s)
- Amine Benadji
- AP-HP, Centre d'Investigation Clinique, Inserm CIC 1425, Hôpital Bichat Claude Bernard, 46, Rue Henri Huchard, 75018, Paris, France
| | - Xavier Duval
- AP-HP, Centre d'Investigation Clinique, Inserm CIC 1425, Hôpital Bichat Claude Bernard, 46, Rue Henri Huchard, 75018, Paris, France. .,IAME, INSERM, Université de Paris, 75018, Paris, France.
| | - Kostas Danis
- Santé Publique France, The French National Public Health Agency, Saint Maurice, France
| | - Bruno Hoen
- Service de Maladies Infectieuses et Tropicales, University Hospital Nancy, Hôpitaux de Brabois, 54511, Vandoeuvre-lès-Nancy, France
| | - Bernard Page
- AP-HP, Intensive Care Unit, Ambroise Paré Hospital, Boulogne-Billancourt, France
| | - Guillaume Béraud
- Médecine Interne et Maladies Infectieuses, CHU de Poitiers, 86021, Poitiers, France
| | | | - Christophe Strady
- Cabinet d'Infectiologie, Clinique Courlancy, Groupe Courlancy-Reims, Reims, France
| | | | - Laurence Maulin
- Infectiologie, Centre Hospitalier du Pays d'Aix, Aix-en-Provence, France
| | - Carine Roy
- AP-HP, Unité de Recherche Clinique, Paris Nord, Hôpital Bichat, Paris, France
| | - Marie-Cécile Ploy
- Regional Observatories for Pneumococci (Observatoires Régionaux du Pneumocoque), University Hospital Centre Limoges, Limoges, France.,INSERM, CHU Limoges, RESINFIT, University of Limoges, U1092, F-87000, Limoges, France
| | | | - Emmanuelle Varon
- National Centre for Pneumococci, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Sarah Tubiana
- AP-HP, Centre d'Investigation Clinique, Inserm CIC 1425, Hôpital Bichat Claude Bernard, 46, Rue Henri Huchard, 75018, Paris, France.,IAME, INSERM, Université de Paris, 75018, Paris, France
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7
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Janssen C, Maillard A, Bodelet C, Claudel AL, Gaillat J, Delory T. Hesitancy towards COVID-19 Vaccination among Healthcare Workers: A Multi-Centric Survey in France. Vaccines (Basel) 2021; 9:547. [PMID: 34067490 PMCID: PMC8224571 DOI: 10.3390/vaccines9060547] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 05/10/2021] [Accepted: 05/19/2021] [Indexed: 12/27/2022] Open
Abstract
Vaccination programs against COVID-19 are being scaled up. We aimed to assess the effects of vaccine characteristics on vaccine hesitancy among healthcare workers in a multi-center survey conducted within French healthcare facilities from 1 December 2020 to 26 March 2021. We invited any healthcare workers naïve of COVID-19 vaccination to complete an online self-questionnaire. They reported on their socio-demographic characteristics, as well as their perception and beliefs towards vaccination. We measured their willingness to get vaccinated in eight scenarios for candidates' vaccines presented sequentially (1 to 4-point scale). Candidates' vaccines varied for efficacy (25%, 50%, 100%), length of immunization (1 year or lifetime), frequency (<1/100, <1/10,000), and severity (none, moderate, severe) of adverse events. We analyzed 4349 healthcare workers' responses with interpretable questionnaires. The crude willingness to get vaccinated was 53.2% and increased over time. We clustered the trajectories of responses using an unsupervised classification algorithm (k-means) and identified four groups of healthcare workers: those willing to get vaccinated in any scenario (18%), those not willing to get vaccinated at all (22%), and those hesitating but more likely to accept (32%) or reject (28%) the vaccination depending on the scenario. In these last two subgroups, vaccine acceptance was growing with age, educational background and was higher among men with condition. Compared to an ideal vaccine candidate, a 50% reduced efficacy resulted in an average drop in acceptance by 0.8 (SD ± 0.8, -23.5%), while it was ranging from 1.4 (SD ± 1.0, -38.4%) to 2.1 (SD ± 1.0, -58.4%) in case of severe but rare adverse event. The acceptance of a mandatory immunization program was 29.6% overall and was positively correlated to the willingness to get vaccinated, ranging from 2.4% to 60.0%. Even if healthcare workers represent a heterogeneous population, most (80%) could accept the vaccination against COVID-19. Their willingness to get the vaccine increased over time and as immunization programs became available. Among hesitant professionals, the fear of adverse events was the main concern. Targeted information campaigns reassuring about adverse events may increase vaccine coverage, in a population with a strong opinion about mandatory immunization programs.
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Affiliation(s)
- Cécile Janssen
- Centre Hospitalier Annecy Genevois, Infectious Diseases Unit, F-74374 Annecy, France;
| | - Alexis Maillard
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
| | - Céline Bodelet
- Laboratoire Inter-universitaire de Psychologie (LIP-PC2S), Université Grenoble, Alpes 1251 Avenue Centrale, 38400 Saint-Martin-d’Hères, France;
| | - Anne-Laure Claudel
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
| | - Jacques Gaillat
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
| | - Tristan Delory
- Centre Hospitalier Annecy Genevois, Clinical Research Unit, F-74374 Annecy, France; (A.M.); (A.-L.C.); (J.G.)
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8
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Dupuis C, Sabra A, Patrier J, Chaize G, Saighi A, Féger C, Vainchtock A, Gaillat J, Timsit JF. Burden of pneumococcal pneumonia requiring ICU admission in France: 1-year prognosis, resources use, and costs. Crit Care 2021; 25:24. [PMID: 33423691 PMCID: PMC7798246 DOI: 10.1186/s13054-020-03442-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 12/16/2020] [Indexed: 01/15/2023]
Abstract
Background Community-acquired pneumonia (CAP), especially pneumococcal CAP (P-CAP), is associated with a heavy burden of illness as evidenced by high rates of intensive care unit (ICU) admission, mortality, and costs. Although well-defined acutely, determinants influencing long-term burden are less known. This study assessed determinants of 28-day and 1-year mortality and costs among P-CAP patients admitted in ICUs. Methods Data regarding all hospital and ICU stays in France in 2014 were extracted from the French healthcare administrative database. All patients admitted in the ICU with a pneumonia diagnosis were included, except those hospitalized for pneumonia within the previous 3 months. The pneumococcal etiology and comorbidities were captured. All hospital stays were included in the cost analysis. Comorbidities and other factors effect on the 28-day and 1-year mortality were assessed using a Cox regression model. Factors associated with increased costs were identified using log-linear regression models. Results Among 182,858 patients hospitalized for CAP in France for 1 year, 10,587 (5.8%) had a P-CAP, among whom 1665 (15.7%) required ICU admission. The in-hospital mortality reached 22.8% at day 28 and 32.3% at 1 year. The mortality risk increased with age > 54 years, malignancies (hazard ratio (HR) 1.54, 95% CI [1.23–1.94], p = 0.0002), liver diseases (HR 2.08, 95% CI [1.61–2.69], p < 0.0001), and the illness severity at ICU admission. Compared with non-ICU-admitted patients, ICU survivors remained at higher risk of 1-year mortality. Within the following year, 38.2% (516/1350) of the 28-day survivors required at least another hospital stay, mostly for respiratory diseases. The mean cost of the initial stay was €19,008 for all patients and €11,637 for subsequent hospital stays within 1 year. One-year costs were influenced by age (lower in patients > 75 years old, p = 0.008), chronic cardiac (+ 11% [0.02–0.19], p = 0.019), and respiratory diseases (+ 11% [0.03–0.18], p = 0.006). Conclusions P-CAP in ICU-admitted patients was associated with a heavy burden of mortality and costs at one year. Older age was associated with both early and 1-year increased mortality. Malignant and chronic liver diseases were associated with increased mortality, whereas chronic cardiac failure and chronic respiratory disease with increased costs. Trial registration N/A (study on existing database)
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Affiliation(s)
- Claire Dupuis
- AP-HP, Medical and Infectious Diseases Intensive Care Unit (MI2), Bichat-Claude Bernard University Hospital, 46 rue Henri Huchard, 75018, Paris, France.,Université de Paris, INSERM IAME, U1137, Team DesCID, 75018, Paris, France.,Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France
| | | | - Juliette Patrier
- AP-HP, Medical and Infectious Diseases Intensive Care Unit (MI2), Bichat-Claude Bernard University Hospital, 46 rue Henri Huchard, 75018, Paris, France
| | | | | | | | | | - Jacques Gaillat
- Infectious Diseases Department, Annecy-Genevois Hospital, Annecy, France
| | - Jean-François Timsit
- AP-HP, Medical and Infectious Diseases Intensive Care Unit (MI2), Bichat-Claude Bernard University Hospital, 46 rue Henri Huchard, 75018, Paris, France. .,Medical ICU, Gabriel-Montpied University Hospital, Clermont-Ferrand, France.
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9
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Mounayar AL, Francois P, Pavese P, Sellier E, Gaillat J, Camara B, Degano B, Maillet M, Bouisse M, Courtois X, Labarère J, Seigneurin A. Development of a risk prediction model of potentially avoidable readmission for patients hospitalised with community-acquired pneumonia: study protocol and population. BMJ Open 2020; 10:e040573. [PMID: 33177142 PMCID: PMC7661353 DOI: 10.1136/bmjopen-2020-040573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
INTRODUCTION 30-day readmission rate is considered an adverse outcome reflecting suboptimal quality of care during index hospitalisation for community-acquired pneumonia (CAP). However, potentially avoidable readmission would be a more relevant metric than all-cause readmission for tracking quality of hospital care for CAP. The objectives of this study are (1) to estimate potentially avoidable 30-day readmission rate and (2) to develop a risk prediction model intended to identify potentially avoidable readmissions for CAP. METHODS AND ANALYSIS The study population consists of consecutive patients admitted in two hospitals from the community or nursing home setting with pneumonia. To qualify for inclusion, patients must have a primary or secondary discharge diagnosis code of pneumonia. Data sources include routinely collected administrative claims data as part of diagnosis-related group prospective payment system and structured chart reviews. The main outcome measure is potentially avoidable readmission within 30 days of discharge from index hospitalisation. The likelihood that a readmission is potentially avoidable will be quantified using latent class analysis based on independent structured reviews performed by four panellists. We will use a two-stage approach to develop a claims data-based model intended to identify potentially avoidable readmissions. The first stage implies deriving a clinical model based on data collected through retrospective chart review only. In the second stage, the predictors comprising the medical record model will be translated into International Classification of Diseases, 10th revision discharge diagnosis codes in order to obtain a claim data-based risk model.The study sample consists of 1150 hospital stays with a diagnosis of CAP. 30-day index hospital readmission rate is 17.5%. ETHICS AND DISSEMINATION The protocol was reviewed by the Comité de Protection des Personnes Sud Est V (IRB#6705). Efforts will be made to release the primary study results within 6 months of data collection completion. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT02833259).
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Affiliation(s)
| | - Patrice Francois
- Medical Assessment, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
| | - Patricia Pavese
- Infectious Diseases, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
| | - Elodie Sellier
- Medical Information, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
| | - Jacques Gaillat
- Medical Information and Assessment, Annecy Genevois Hospital Centre, Epagny Metz-Tessy, Rhône-Alpes, France
| | - Boubou Camara
- Pneumology Department, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
| | - Bruno Degano
- Pneumology Department, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
| | - Mylène Maillet
- Infectious Diseases, Annecy Genevois Hospital Centre, Epagny Metz-Tessy, Rhône-Alpes, France
| | - Magali Bouisse
- Medical Assessment, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
| | - Xavier Courtois
- Medical Information and Assessment, Annecy Genevois Hospital Centre, Epagny Metz-Tessy, Rhône-Alpes, France
| | - José Labarère
- Medical Assessment, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
- BCM, Laboratoire TIMC-IMAG, La Tronche, Rhône-Alpes, France
| | - Arnaud Seigneurin
- Medical Assessment, CHU Grenoble Alpes, Grenoble, Rhône-Alpes, France
- BCM, Laboratoire TIMC-IMAG, La Tronche, Rhône-Alpes, France
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10
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Fouad F, Lemaitre M, Carrat F, Crépey P, Gaillat J, Launay O, Mosnier A, Gavazzi G, Levant M, Uhart M. Estimation du fardeau hospitalier direct et attribuable à la grippe en France à partir de la base PMSI. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Ecarnot F, Crepaldi G, Juvin P, Grabenstein J, Del Giudice G, Tan L, O'Dwyer S, Esposito S, Bosch X, Gavazzi G, Papastergiou J, Gaillat J, Johnson R, Fonzo M, Rossanese A, Suitner C, Barratt J, di Pasquale A, Maggi S, Michel JP. Pharmacy-based interventions to increase vaccine uptake: report of a multidisciplinary stakeholders meeting. BMC Public Health 2019; 19:1698. [PMID: 31852470 PMCID: PMC6921486 DOI: 10.1186/s12889-019-8044-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 12/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the existence of efficacious vaccines, the burden of vaccine-preventable diseases remains high and the potential health benefits of paediatric, adolescent and adult vaccination are not being achieved due to suboptimal vaccine coverage rates. Based on emerging evidence that pharmacy-based vaccine interventions are feasible and effective, the European Interdisciplinary Council for Ageing (EICA) brought together stakeholders from the medical and pharmacy professions, the pharmaceutical industry, patient/ageing organisations and health authorities to consider the potential for pharmacy-based interventions to increase vaccine uptake. We report here the proceedings of this 3-day meeting held in March 2018 in San Servolo island, Venice, Italy, focussing firstly on examples from countries that have introduced pharmacy-based vaccination programmes, and secondly, listing the barriers and solutions proposed by the discussion groups. CONCLUSIONS A range of barriers to vaccine uptake have been identified, affecting all target groups, and in various countries and healthcare settings. Ease of accessibility is a potentially modifiable determinant in vaccine uptake, and thus, improving the diversity of settings where vaccines can be provided to adults, for example by enabling community pharmacists to vaccinate, may increase the number of available opportunities for vaccination.
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Affiliation(s)
- Fiona Ecarnot
- EA3920, University of Franche-Comté, Besancon, France. .,Department of Cardiology, University Hospital Jean Minjoz, Boulevard Fleming, 25000, Besancon, France.
| | | | - Philippe Juvin
- Global Product Quality Management, Sanofi Pasteur, Lyon, France
| | - John Grabenstein
- Executive Director, Global Vaccines Medical Affairs, Merck Research Laboratories, North Wales, PA 19454, USA
| | - Giuseppe Del Giudice
- Translational Science Leader, R&D Center Italy, GSK Vaccines Srl, 53100, Siena, Italy
| | - Litjen Tan
- Chief Strategy Officer, Immunization Action Coalition, United States; Co-Chair, National Adult and Influenza Immunization Summit, Saint Paul, MN, USA
| | - Susan O'Dwyer
- Boots Retail (Ireland) Limited, Nangor Road, Clondalkin, Dublin, 12, Ireland
| | - Susanna Esposito
- Pediatric Clinic, Department of Biomedical and Surgical Sciences, Università degli Studi di Perugia, Perugia, Italy
| | - Xavier Bosch
- Catalan Institute of Oncology, Cancer Epidemiology Research Program, L'Hospitalet de Llobregat (Barcelona), Barcelona, Spain
| | - Gaetan Gavazzi
- University of Grenoble-Alpes, GREPI, FRE 3405 CNRS and University Clinic of Geriatric Medicine, University hospital of Grenoble, Grenoble, France
| | - John Papastergiou
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | | | - Robert Johnson
- Hon. Senior Research Fellow, Faculty of Health Sciences: Emeritus Consultant in Pain Medicine, University of Bristol, Bristol, UK
| | - Marco Fonzo
- DCTV - Department of Cardiac, Thoracic and Vascular Sciences, Hygiene and Public Health Unit, University of Padua, Padua, Italy
| | - Andrea Rossanese
- Centre for Tropical Diseases, "Sacro Cuore - Don Calabria" Hospital, Negrar, Verona, Italy
| | - Caterina Suitner
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Jane Barratt
- International Federation on Ageing, Toronto, Ontario, Canada
| | | | - Stefania Maggi
- CNR, Institute of Neuroscience - Aging Branch, Padua, Italy
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12
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Danis K, Varon E, Lepoutre A, Janssen C, Forestier E, Epaulard O, N'guyen Y, Labrunie A, Lanotte P, Gravet A, Pelloux I, Chavanet P, Levy-Bruhl D, Ploy MC, Gaillat J. Factors Associated With Severe Nonmeningitis Invasive Pneumococcal Disease in Adults in France. Open Forum Infect Dis 2019; 6:ofz510. [PMID: 31868865 PMCID: PMC6918451 DOI: 10.1093/ofid/ofz510] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/28/2019] [Indexed: 11/14/2022] Open
Abstract
Background In France, pneumococcal vaccination in adults is recommended for risk groups (chronic conditions/immunosuppression). We conducted a study on invasive pneumococcal disease (IPD) in adults to identify factors associated with disease severity and death. Methods We included IPD cases, excluding meningitis, from 25 acute care hospitals in 6 regions. We defined severe cases as those with shock or severe sepsis or intensive care unit admission/mechanical ventilation. We included deaths occurring within 30 days of hospitalization. Infectious disease specialists collected clinical/microbiological data on cases. Results During 2014–2017, 908 nonmeningitis IPD cases were diagnosed; 48% were severe, 84% had comorbidities, 21% died. Ninety percent of cases with comorbidities who previously sought health care were not vaccinated against pneumococcus. Compared with previously healthy cases, the risk of severe IPD increased from 20% (adjusted risk ratio [aRR], 1.2; 95% confidence interval [CI], 1.0–1.4) in cases with 1–2 chronic diseases to 30% (aRR, 1.3; 95% CI, 1.0–7.0) in those with >2 chronic diseases. Among risk groups, 13-valent pneumococcal conjugate vaccine (PCV13) serotypes and 23-valent pneumococcal polysaccharide vaccine (PPSV23) nonPCV13 serotypes were more likely to induce severe IPD compared with nonvaccine serotypes (aRR, 1.5; 95% CI, 1.3–1.9; aRR, 1.3; 95% CI, 1.0–1.5, respectively). Conclusions We observed a cumulative effect of concurrent comorbidities on severe IPD. Vaccine serotypes were more likely to induce severe IPD among risk groups. The missed opportunities for vaccination underscore the need to enhance vaccination in risk groups.
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Affiliation(s)
- Kostas Danis
- Santé Publique France (SpFrance), the French National Public Health Agency, Saint-Maurice, France
| | - Emmanuelle Varon
- National Centre for Pneumococci, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - Agnès Lepoutre
- Santé Publique France (SpFrance), the French National Public Health Agency, Saint-Maurice, France
| | | | | | | | | | - Anaïs Labrunie
- University Hospital Centre Limoges, Regional Observatories for Pneumococci (Observatoires Régionaux du Pneumocoque), Limoges, France.,University Hospital Centre Limoges, CEBIMER, Limoges, France
| | | | - Alain Gravet
- Hospital Emile Müller Mulhouse, Mullhouse, France
| | | | | | - Daniel Levy-Bruhl
- Santé Publique France (SpFrance), the French National Public Health Agency, Saint-Maurice, France
| | - Marie-Cecile Ploy
- University Hospital Centre Limoges, Regional Observatories for Pneumococci (Observatoires Régionaux du Pneumocoque), Limoges, France.,University Limoges, INSERM, CHU Limoges, RESINFIT, , Limoges, France
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13
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Danis K, Ploy MC, Varon E, Levy-Bruhl D, Gaillat J. Severe outcomes following invasive pneumococcal disease in adults in France. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Pneumococcal vaccine serotypes and host factors may increase the risk of severe invasive pneumococcal disease (IPD). In France, pneumococcal vaccination in adults is recommended for at-risk groups (immunosuppression or at-risk conditions/diseases). In 2014-2017, we conducted a study of IPD in adults to identify factors/serotypes associated with disease severity.
We included IPD cases, excluding meningitis, in adults from 25 acute-care sentinel hospitals in six regions. Severe cases were IPD patients either admitted to an ICU or under mechanical ventilation or with severe sepsis or shock. Infectious disease specialists collected clinical/microbiological data on all cases. We calculated adjusted risk ratios (aRR) using binomial regression.
In 2014-2017, 908 cases (median age 71 (range 18-101) years) were diagnosed; 48%(431/908) were severe and 84%(764/908) were at-risk. Compared with non-risk individuals, the risk of severe disease increased from 20% (aRR 1.2; 95%CI 1.0-1.4) in cases with 1-2 chronic diseases to 30% (aHR 1.3; 95%CI 1.0-7.0) in those with >2 chronic diseases. The risk of severe disease was 42% (aRR 1.4; 95%CI 1.2-1.6) higher for PCV13 serotypes compared with non-vaccine serotypes. Among cases infected with PCV13 serotypes, the risk of severe disease did not differ (aRR 0.96; 95%CI 1.2-23) between no-risk or at-risk cases. However, among cases infected with non-vaccine serotypes, the risk increased 49% (aRR 1.5; 95%CI 2.1-22) in at-risk compared with no-risk cases (homogeneity test p = 0.03).
We observed a cumulative effect of concurrent comorbidities on severe IPD outcomes. The risk of severe IPD increased for vaccine serotypes regardless of risk status. However, non-vaccine serotypes increased the risk of severe outcomes only in risk groups, suggesting a different interplay between host factors and the pathogen in vulnerable groups. We recommend enhancing vaccination among risk groups and especially in those most at risk for poor IPD-related outcomes.
Key messages
Cumulative effect of concurrent comorbidities on severe invasive pneumococcal disease outcomes. Non-vaccine serotypes increase the risk of severe invasive pneumococcal disease outcomes only in vulnerable groups.
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Affiliation(s)
- K Danis
- Department of Infectious Diseases, Santé Publique France, Saint Maurice, France
| | - M C Ploy
- CHU de Limoges, University of Limoges, Limoges, France
| | - E Varon
- National Centre for Pneumococci, Centre Hospitalier Intercommunal Créteil, Créteil, France
| | - D Levy-Bruhl
- Department of Infectious Diseases, Santé Publique France, Saint Maurice, France
| | - J Gaillat
- Centre Hospitalier Annecy Genevois, Annecy, France
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14
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Abstract
INTRODUCTION We are at a "post-trust" period, characterised by vaccine hesitancy which is being widely diffused by the media and social networks. The consequences of this include: measles, whooping cough epidemics, vaccine coverage decreasing for the youngest, and remaining at low levels in adults. Mandatory vaccination has been extended for children less than two years in France, with the objective to increase vaccination rates during this period. STATE OF THE ART The medical literature on this topic is increasing, mainly regarding descriptions of reasons for vaccine hesitancy. These include doubt about vaccine efficacy, safety, and real need as well as with regard to social aspects, cultural, religious beliefs. The literature that explores the best way to address vaccine hesitancy is still scarce. Healthcare workers are a key in promoting vaccine acceptance. There is a need to address the issue of vaccine hesitancy in a multicompartmental way. Health authorities must communicate in a clear and concise style that is trust-based and science-informed, being transparent both on vaccine benefits and on issues around vaccine safety. For caregivers, motivational interviewing can help patients change behaviour. CONCLUSION Anti-vaccine ideas were born with vaccines; they are abundantly spread through the Internet and social networks and can give a false impression of their basis in reality. It is time for positive action not merely a defensive approach.
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Affiliation(s)
- J Gaillat
- Centre de recherche clinique, service des maladies infectieuses CHANGE, centre hospitalier Annecy-Genevois, 1, avenue de l'hôpital, 74374 Pringy cedex, France.
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15
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Mosnier A, Launay O, Martinez L, Gavazzi G, Josset L, Crepey P, Hannoun C, Weil-Olivier C, Gaillat J. [Quadrivalent influenza vaccine: What is changed and what are the benefits?]. Presse Med 2018; 47:842-853. [PMID: 30219205 DOI: 10.1016/j.lpm.2018.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022] Open
Abstract
Currently, circulating viruses responsible for annual seasonal influenza epidemics belong to two influenza A subtypes, A(H1N1) and A(H3N2), and to two antigenically distinct type B lineages, B/Yamagata and B/Victoria lineages. Like diseases due to influenza A virus, influenza B virus diseases may have severe consequences and should be prevented. Until now, in France, the vaccines used to prevent seasonal influenza were trivalent, systematically targeting viruses belonging to both A subtypes and to one or other of the B lineages. The protective efficacy of trivalent vaccines is diminished during the seasons when viruses belonging to both B lineages cocirculated or when the circulating dominant type B virus belonged to a lineage different from that targeted by the vaccine strain. By targeting viruses belonging to both B lineages, quadrivalent vaccines improve the antigenic concordance between circulating and vaccine type B strains. Three inactivated quadrivalent vaccines are authorized for marketing in France and should be available for the 2018-2019 season. It is expected that, by providing enlarged protection, these quadrivalent influenza vaccines will improve vaccine efficacy, the confidence in immunization of the public, the satisfaction of health professionals, and ultimately will help to complete immunization coverage.
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Affiliation(s)
- Anne Mosnier
- Open Rome & Réseau des GROG, 67, rue du Poteau, 75018 Paris, France
| | - Odile Launay
- Assistance publique-Hôpitaux de Paris, hôpital Cochin, université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France
| | | | - Gaëtan Gavazzi
- CHU Grenoble-Alpes, clinique universitaire de gériatrie, pavillon Elisée-Chatin, et GREPI EA 7408, université Grenoble-Alpes, CS 10217, 38043 Grenoble cedex 9, France
| | - Laurence Josset
- Institut des agents infectieux, 103, grande rue de la Croix-Rousse, 69004 Lyon, France
| | | | | | | | - Jacques Gaillat
- Centre hospitalier Annecy-Genevois, 1, avenue de l'Hôpital, 74370 Metz-Tessy, France.
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16
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Epaulard O, Chavanet P, Lanotte P, Launay O, Lévy-bruhl D, Mootien J, Ploy M, Strady C, Gaillat J, Varon E. La vaccination anti-pneumococcique est insuffisamment réalisée chez les patients à risque : à propos de 693 cas d’infections invasives à pneumocoque. Med Mal Infect 2018. [DOI: 10.1016/j.medmal.2018.04.084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Saba G, Andrade LF, Gaillat J, Bonnin P, Chidiac C, Illes HG, Laurichesse H, Messika J, Ricard JD, Detournay B, Petitpretz P, de Pouvourville G. Costs associated with community acquired pneumonia in France. Eur J Health Econ 2018; 19:533-544. [PMID: 28547724 DOI: 10.1007/s10198-017-0900-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 05/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context. METHODS Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6. Descriptive statistics and multivariate analyses were performed. We used generalized linear models with log-link functions to estimate parameters associated with hospital and follow-up costs of patients. RESULTS Five hundred twenty-four patients were enrolled in 40 public centers from October 2011 to April 2014. Average age was 63 (SD 17); 55.0% of them were male. Average length of stay was 15 days (SD 23). Average cost of stay for the French Sickness Fund was €7293 (SD €7363). Average cost of follow-up was €1242 (SD €3000) and decreased steadily through time. When controlling for patient's socioeconomic characteristics, severity of disease and hospital stay, results showed a concave relationship between hospital costs and age. Obesity, the severity of the disease and comorbidities were associated with constantly increasing inpatient costs. Concerning follow-up costs, we found the same concave relationship with age, while gender, a history of pneumonia and severity of the disease were the most important predictors of high costs after discharge. CONCLUSION Pneumocost is the first French study providing a robust estimation of the cost of managing invasive pneumococcal pneumonia in the French context.
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Affiliation(s)
- Grèce Saba
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France
| | - Luiz Flavio Andrade
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France.
| | | | | | | | | | - Henri Laurichesse
- Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jonathan Messika
- AP-HP, Hôpital Louis Mourier, Service de Réanimation Médico-Chirurgicale, 178 rue des Renouillers, 92700, Colombes, France
- INSERM, IAME, UMR 1137, 75018, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, 75018, Paris, France
| | - Jean-Damien Ricard
- AP-HP, Hôpital Louis Mourier, Service de Réanimation Médico-Chirurgicale, 178 rue des Renouillers, 92700, Colombes, France
- INSERM, IAME, UMR 1137, 75018, Paris, France
- Univ Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, 75018, Paris, France
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18
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Torres A, Cillóniz C, Blasi F, Chalmers JD, Gaillat J, Dartois N, Schmitt HJ, Welte T. Burden of pneumococcal community-acquired pneumonia in adults across Europe: A literature review. Respir Med 2018; 137:6-13. [PMID: 29605214 DOI: 10.1016/j.rmed.2018.02.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/09/2018] [Accepted: 02/10/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND The burden of community-acquired pneumonia (CAP) caused by Streptococcus pneumoniae (pneumococcus) among adults in Europe is poorly defined. METHODS Structured searches of PubMed were conducted to identify the incidence of pneumococcal CAP among adults across Europe. RESULTS The overall incidence rates for CAP was 68-7000 per 100,000 and the incidence in hospitalised CAP cases of all causes was 16-3581 per 100,000. In general the incidence of CAP increased consistently with age. Available data indicated higher burdens of pneumococcal CAP caused in groups with more comorbidities. Most cases of pneumococcal CAP (30%-78%) were caused by serotypes covered by PCV13 vaccine; the incidence of PCV13-related pneumonia decreased after the introduction of childhood vaccination. CONCLUSIONS We observed a high burden adult pneumococcal CAP in Europe despite use of the 23-valent pneumococcal polysaccharide vaccine, particularly in elderly patients with comorbidities. CAP surveillance presented wide variations across Europe. Pneumococcal CAP has to be monitored very carefully due to the possible effect of current vaccination strategies.
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Affiliation(s)
- Antoni Torres
- Department of Pulmonology, Hospital Clínic, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Spain.
| | - Catia Cillóniz
- Department of Pulmonology, Hospital Clínic, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Spain
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, Università degli Studi di Milanoand Internal Medicine Department, Respiratory Unit and Adult Cystic Fibrosis Center Fondazione IRCCS Cà Granda Ospedale, Maggiore Policlinico, Milano, Italy
| | - James D Chalmers
- College of Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, DD1 9SY, UK
| | - Jacques Gaillat
- Infectious Diseases Department Centre Hospitalier Annecy Genevois, 1 avenue de l'Hôpital, 74374 Pringy, France
| | - Nathalie Dartois
- Pfizer Vaccines, Medical and Scientific Affairs, 23-25 avenue du Dr. Lannelongue, F-75668 Paris Cedex 14, France
| | - Heinz-Josef Schmitt
- Pfizer Vaccines, Medical and Scientific Affairs, 23-25 avenue du Dr. Lannelongue, F-75668 Paris Cedex 14, France
| | - Tobias Welte
- Department of Respiratory Medicine, Medizinische Hochschule, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
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19
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Andrade LF, Saba G, Ricard JD, Messika J, Gaillat J, Bonnin P, Chidiac C, Illes HG, Laurichesse H, Detournay B, Petitpretz P, de Pouvourville G. Health related quality of life in patients with community-acquired pneumococcal pneumonia in France. Health Qual Life Outcomes 2018; 16:28. [PMID: 29394941 PMCID: PMC5797362 DOI: 10.1186/s12955-018-0854-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 01/25/2018] [Indexed: 12/21/2022] Open
Abstract
Background Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. Methods A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients. We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values. Results Average age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. “Usual activities” was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge. Conclusion This study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.
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Affiliation(s)
- Luiz Flavio Andrade
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France.
| | - Grèce Saba
- ESSEC Business School, Avenue Bernard Hirsch, 95021, Cergy-Pontoise Cedex, France
| | - Jean-Damien Ricard
- Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Colombes, France.,INSERM, IAME, UMR 1137, University of Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018, Paris, France
| | - Jonathan Messika
- Hôpital Louis Mourier, Assistance Publique Hôpitaux de Paris, Colombes, France.,INSERM, IAME, UMR 1137, University of Paris Diderot, IAME, UMR 1137, Sorbonne Paris Cité, F-75018, Paris, France
| | | | | | | | | | - Henri Laurichesse
- Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
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Guiso N, Gallais JL, Gavazzi G, Pinquier D, Gaillat J. Incidence of pertussis in subjects aged 50years and older in France in 2013-2014. Med Mal Infect 2017; 48:30-36. [PMID: 29037454 DOI: 10.1016/j.medmal.2017.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/03/2017] [Accepted: 09/01/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the incidence of pertussis (whooping cough) in subjects aged 50years and older in France. METHODS Participating family physicians (FPs) using the patient record management software AxiSanté® included patients aged 50years and older, who had signed an informed consent form, presenting with persistent cough for 7 to 21days. Bordetella genetic material was detected by polymerase chain reaction (PCR) on nasopharyngeal samples collected at the FP's discretion. RESULTS A total of 42 FPs included 129 patients from June 2013 to August 2014 (large cities: 38; medium-sized cities: 57; rural areas: 34); 106 samples were analyzed. Overall, 30 pertussis cases were diagnosed: 10 cases confirmed by PCR, 18 purely clinical cases, and two direct epidemiological cases. The crude incidence rate per 100,000 patients aged≥50years was 103.6 (95% CI: 69.9-47.9): 77.1 in large cities, 103.1 in medium-sized cities, and 143.9 in rural areas. The extrapolated incidence rate per 100,000 persons aged≥50years was 187.1 (95% CI: 126.2-67.1): 131.1 in large cities, 256.1 in medium-sized cities, and 242.2 in rural areas. CONCLUSION The population aged 50years and older can serve as a reservoir. Its role in Bordetella pertussis circulation should be taken into account for pertussis booster vaccination programs.
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Affiliation(s)
- N Guiso
- Institut Pasteur, unité de prévention et thérapies moléculaires des maladies humaines, 25-28, rue du Docteur-Roux, 75724 Paris cedex 15, France.
| | - J-L Gallais
- Société française de médecine générale (SFMG), 141, avenue de Verdun, 92130 Issy-les-Moulineaux, France
| | - G Gavazzi
- Clinique universitaire de médecine gériatrique, université Grenoble-Alpes, GREPI AGIM, CHU de Grenoble, boulevard de La Chantourne, 38700 La Tronche, France
| | - D Pinquier
- Service de pédiatrie néonatale et réanimation, hôpital Charles-Nicolle, pavillon Mère-et-Enfant, 1, rue de Germont, 76031 Rouen cedex, France
| | - J Gaillat
- Service des maladies infectieuses et médecine interne, centre hospitalier d'Annecy Genevois, 1, avenue de l'Hôpital, Metz-Tessy, BP 90074, 74374 Pringy cedex, France
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Vitrat V, Jean A, Tonnerre O, Hubscher M, Chanzy B, Janssen C, Gaillat J. Stratégie de lutte contre la grippe nosocomiale dans un centre hospitalier non universitaire. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Roubaud-Baudron C, Forestier E, Fraisse T, Gaillat J, de Wazières B, Pagani L, Ingrand I, Bernard L, Gavazzi G, Paccalin M. Tolerance of subcutaneously administered antibiotics: a French national prospective study. Age Ageing 2017; 46:151-155. [PMID: 28181635 DOI: 10.1093/ageing/afw143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 06/15/2016] [Indexed: 11/12/2022] Open
Abstract
Background/ Objective Although poorly documented, subcutaneous (SC) administration of antibiotics is common practice in France especially in Geriatrics Departments. The aim of this study was to determine the tolerance of such a practice. Design Prospective observational multicentre study. Methods Sixty-six physicians accepted to participate from 50 French Infectious Diseases and Geriatrics Departments. From May to September 2014, patients treated at least one day with SC antibiotics could be included. Modalities of subcutaneous administration, occurrence of local and systemic adverse effects (AE) and clinical course were collected until the end of the treatment. Results Two hundred-nineteen patients (83.0 [19–104] yo) were included. Ceftriaxone (n = 163, 74.4%), and ertapenem (n = 30, 13.7%) were the most often prescribed antibiotics. The SC route was mainly used because of poor venous access (65.3%) and/or palliative care (32.4%). Fifty patients (22.8%) experienced at least one local AE that led to an increased hospital stay for two patients (4.0%) and a discontinuation of the SC infusion in six patients (12.0%). A binary logistic regression for multivariate analysis identified the class of antibiotic (p = 0.002) especially teicoplanin and the use of rigid catheter (p = 0.009) as factors independently associated with AE. In over 80% of cases, SC antibiotics were well tolerated and associated with clinical recovery. Conclusions SC administration of antibiotics leads to frequent but local and mild AE. Use of non-rigid catheter appears to be protective against AE. As it appears to be a safe alternative to the intravenous route, more studies are needed regarding efficacy and pharmacokinetics.
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Affiliation(s)
- Claire Roubaud-Baudron
- Pôle de Gérontologie Clinique, Centre Hospitalier Universitaire - Hôpitaux de Bordeaux, Université de Bordeaux, F-33000 Bordeaux, France
| | - Emmanuel Forestier
- Service de Maladies Infectieuses, Centre Hospitalier Métropole Savoie, F-73000 Chambéry, France
| | - Thibaut Fraisse
- Court Séjour Gériatrique Aigu, Centre Hospitalier Alès-Cévennes, F-30100 Alès, France
| | - Jacques Gaillat
- Service de Maladies Infectieuses, Centre Hospitalier Annecy Genevois, F-74000 Annecy, France
| | - Benoit de Wazières
- Médecine Interne Gériatrique, Centre Hospitalier Universitaire de Nîmes, F-30000 Nimes, France
| | - Leonardo Pagani
- Service de Maladies Infectieuses, Centre Hospitalier Annecy Genevois, F-74000 Annecy, France
| | - Isabelle Ingrand
- Pôle Biologie, Pharmacie et Santé Publique, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, F-86000 Poitiers, France
- INSERM, CIC 1402, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, F-86000 Poitiers, France
| | - Louis Bernard
- Service de Maladies Infectieuses, Centre Hospitalier Régional Universitaire Bretonneau, F-37000 Tours, France
| | - Gaëtan Gavazzi
- Clinique Universitaire de Médecine Gériatrique, Centre Hospitalier Universitaire de Grenoble, F-38000 Grenoble, France
| | - Marc Paccalin
- Pôle de Gériatrie, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, F-86000 Poitiers, France
- Intergroupe SPILF-SFGG
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Chidiac C, Bonnin P, Detournay B, Illes HG, Gaillat J, Laurichesse H, Messika J, Ricard JD, Saba G, Petitpretz P, Pouvourville GD. Streptococcus pneumoniae Community-Acquired Pneumonia (SP-CAP) in a French Cohort of Hospitalized Patients: Economic Burden and Impact on Quality of Life (QoL). Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Christian Chidiac
- ID Department, Regional Reference Center for Bji, Hospices Civils de Lyon, Lyon, France
| | | | | | | | | | | | | | | | - Grèce Saba
- Chair of Health Systems, ESSEC Business School, Cergy-Pontoise, France
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Beaufils E, Dommergues MA, Gaillat J, Guiso N, Knezovic-Daniel N, Pinquier D, Riethmuller D. Coqueluche : où en est-on en France 10ans après la mise en place de la stratégie vaccinale du cocooning ? ACTA ACUST UNITED AC 2016; 44:591-597. [DOI: 10.1016/j.gyobfe.2016.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/12/2016] [Indexed: 11/25/2022]
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Chidiac C, Laurichesse H, Illes HG, Gaillat J, Bonnin P, Ricard JD, Messika J, Detournay B, Saba G, Petitpretz P, de Pouvourville G. Coût des pneumonies communautaires à pneumocoque hospitalisées en France. Résultats intermédiaires de l’étude prospective PNEUMOCOST. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Esposito S, Bonanni P, Maggi S, Tan L, Ansaldi F, Lopalco PL, Dagan R, Michel JP, van Damme P, Gaillat J, Prymula R, Vesikari T, Mussini C, Frank U, Osterhaus A, Celentano LP, Rossi M, Guercio V, Gavazzi G. Recommended immunization schedules for adults: Clinical practice guidelines by the Escmid Vaccine Study Group (EVASG), European Geriatric Medicine Society (EUGMS) and the World Association for Infectious Diseases and Immunological Disorders (WAidid). Hum Vaccin Immunother 2016; 12:1777-94. [PMID: 27135390 PMCID: PMC4964839 DOI: 10.1080/21645515.2016.1150396] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 12/27/2022] Open
Abstract
Rapid population aging has become a major challenge in the industrialized world and progressive aging is a key reason for making improvement in vaccination a cornerstone of public health strategy. An increase in age-related disorders and conditions is likely to be seen in the near future, and these are risk factors for the occurrence of a number of vaccine-preventable diseases. An improvement in infectious diseases prevention specifically aimed at adults and the elderly can therefore also decrease the burden of these chronic conditions by reducing morbidity, disability, hospital admissions, health costs, mortality rates and, perhaps most importantly, by improving the quality of life. Among adults, it is necessary to identify groups at increased risk of vaccine-preventable diseases and highlight the epidemiological impact and benefits of vaccinations using an evidence-based approach. This document provides clinical practice guidance on immunization for adults in order to provide recommendations for decision makers and healthcare workers in Europe. Although immunization is considered one of the most impactful and cost-effective public health measures that can be undertaken, vaccination coverage rates among adults are largely lower than the stated goal of ≥ 95% among adults, and stronger efforts are needed to increase coverage in this population. Active surveillance of adult vaccine-preventable diseases, determining the effectiveness of the vaccines approved for marketing in the last 5 y, the efficacy and safety of vaccines in immunocompromised patients, as well as in pregnant women, represent the priorities for future research.
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Affiliation(s)
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, University of Milan, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stefania Maggi
- CNR - Institute of Neuroscience, Aging Branch Center for Research, Padua, Italy
| | - Litjan Tan
- Immunization Action Coalition, St Paul, MN, USA
| | - Filippo Ansaldi
- Department of Health Sciences, University of Genoa, IRCCS San Martino-IST University Teaching Hospital, Genoa, Italy
| | | | - Ron Dagan
- Pediatric Infectious Disease Unit, Soroka University Medical Center and the Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | | | - Pierre van Damme
- Vaccine & Infectious Disease Institute, Antwerp University, Wilrijk, Belgium
| | | | - Roman Prymula
- Department of Social Medicine, Faculty of Medicine, Charles University, Sokolska, Hradec Kralove, Czech Republic
| | - Timo Vesikari
- Vaccine Research Center, Tampere University Hospital, Tampere, Finland
| | - Cristina Mussini
- Clinic of Infectious Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - Uwe Frank
- Division of Infection Control and Hospital Epidemiology, Department of Infectious Diseases, Heidelberg University, Heidelberg, Germany
| | | | | | - Marta Rossi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valentina Guercio
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Gaetan Gavazzi
- University Clinic of Geriatric Medicine, University Hospital of Grenoble, and GREPI University of Grenoble-Alpes, Grenoble, France
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de Pouvourville G, Petitprez P, Saba G, Chidiac C, Gaillat J, Laurichesse H, Bonnin P, Ricard J, Messika J, Detournay B. SP-07 - Qualité de vie des patients hospitalisés après un épisode d’infection au pneumocoque. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30508-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gaillat J, Varon E, Lanotte P, Lepoutre A, Pelloux I, Epaulard O, Bernard L, Chavanet P, Mootien Y. COL 2-02 - Surveillance épidémiologique clinico-microbiologique des infections invasives à pneumocoque de l’adulte (IIP) (SIIPA). Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lepoutre A, Ploy M, Gaillat J, Forestier E, Sifaoui F, Guinard J, Janssen C, Tellini C, Lévy-Bruhl D, Varon E. COL 2–01 - Épidémiologie des infections invasives à pneumocoque de l’adulte en France et recommandations vaccinales, résultat de la cohorte Surveillance des infections invasives à pneumocoques (SIIP) de l’adulte. Med Mal Infect 2016. [DOI: 10.1016/s0399-077x(16)30261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Pickering G, Gavazzi G, Gaillat J, Paccalin M, Bloch K, Bouhassira D. Is herpes zoster an additional complication in old age alongside comorbidity and multiple medications? Results of the post hoc analysis of the 12-month longitudinal prospective observational ARIZONA cohort study. BMJ Open 2016; 6:e009689. [PMID: 26892790 PMCID: PMC4762078 DOI: 10.1136/bmjopen-2015-009689] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To examine the burden of comorbidity, polypharmacy and herpes zoster (HZ), an infectious disease, and its main complication post-herpetic neuralgia (PHN) in young (50-70 years of age: 70-) and old (≥ 70 years of age: 70+) patients. DESIGN Post hoc analysis of the results of the 12-month longitudinal prospective multicentre observational ARIZONA cohort study. SETTINGS AND PARTICIPANTS The study took place in primary care in France from 20 November 2006 to 12 September 2008. Overall, 644 general practitioners (GPs) collected data from 1358 patients aged 50 years or more with acute eruptive HZ. OUTCOME MEASURES Presence of HZ-related pain or PHN (pain persisting >3 months) was documented at day 0 and at months 3, 6, and 12. To investigate HZ and PHN burden, pain, quality of life (QoL) and mood were self-assessed using validated questionnaires (Zoster Brief Pain Inventory, 12-item Short-Form health survey and Hospital Anxiety and Depression Scale, respectively). RESULTS As compared with younger patients, older patients more frequently presented with comorbidities, more frequently took analgesics and had poorer response on all questionnaires, indicating greater burden, at inclusion. Analgesics were more frequently prescribed to relieve acute pain or PHN in 70+ than 70- patients. Despite higher levels of medication prescription, poorer pain relief and poorer response to all questionnaires were reported in 70+ than 70- patients. CONCLUSIONS Occurrence of HZ and progression to PHN adds extra burden on top of pharmacological treatment and impaired quality of life, especially in older patients who already have health problems to cope with in everyday life.
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Affiliation(s)
- Gisèle Pickering
- CHU Clermont-Ferrand, Centre de Pharmacologie Clinique, F-63003 Clermont-Ferrand, France
- Inserm CIC 1405, Inserm 1107, Clermont-Ferrand, France
- Clermont Université, Laboratoire de Pharmacologie, Faculté de Médecine, Clermont-Ferrand, France
| | - Gaëtan Gavazzi
- Département de Gériatrie, CHU de Grenoble, Grenoble, France
| | - Jacques Gaillat
- Service des Maladies Infectieuses, Centre Hospitalier de la Région d'Annecy, Pringy, France
| | - Marc Paccalin
- Département de Gériatrie, Hôpital de la Milétrie, CHU de Poitiers, Poitiers, France
| | | | - Didier Bouhassira
- INSERM U987, Centre d'Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, Boulogne-Billancourt, France
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Mailles A, Gaillat J, Rautureau S, Garin-Bastuji B, Hars J, Tattevin P, Catelinois O, Bourg VL, Mick V, Lucht F, Vaillant V, Garau J, Stahl JP, Bru JP. Re-Emergence of Brucellosis in Cattle and Humans From a Silent Wildlife Reservoir and Consequences on Human Exposures Management in a Brucellosis-Free Country. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Casez P, Fauconnier J, Jorgensen L, Gutterman EM, Gray S, Munson S, Dartois N, Gaillat J. Longitudinal DRG-based survey of all-cause and pneumococcal pneumonia and meningitis for inpatients in France (2005-2010). Med Mal Infect 2015; 45:446-55. [PMID: 26607227 DOI: 10.1016/j.medmal.2015.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 06/09/2015] [Accepted: 10/02/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This population-based retrospective study quantified the burden of all-cause and pneumococcal pneumonia and meningitis in the Rhône-Alpes region of France from 2005 to 2010, when the 7-valent pneumococcal conjugate vaccine uptake increased from 50 to>90% in children. PATIENTS AND METHODS Hospital admission data was obtained from the French Diagnosis Related Groups program database (French acronym PMSI). Patients were residents of the Rhône-Alpes region hospitalized for the diseases of interest during 2005-2010. Hospitalization and in-hospital mortality rates were calculated by age, sex, and year on the basis of the Rhône-Alpes region population. Hospitalization and in-hospital mortality rates were compared using Chi(2) tests with statistical significance adjusted for multiple comparisons. RESULTS The highest hospitalization rates by age group were: all-cause pneumonia, oldest group (>65 years); all-cause and pneumococcal meningitis, youngest group (0-4 years), and pneumococcal pneumonia, youngest and oldest groups. Hospitalization rates significantly decreased for all-cause pneumonia (5-19 years: -12.71%) and all-cause meningitis (20-49 years: -29.22%). Pneumococcal disease rates did not significantly change in any age group. Mortality rates from all-cause pneumonia and meningitis were highest in the oldest age groups. CONCLUSIONS The burden of all-cause and pneumococcal pneumonia and meningitis remains substantial. Significant changes (decreases) between 2005 and 2010 in hospitalization rates were limited and varied among age groups, most likely because this study began 2 years after PCV7 was first introduced in France for children at broadly-defined high risk. Further research is needed on the relationship between serotype epidemiology and clinical patterns of disease.
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Affiliation(s)
- P Casez
- Service d'information et d'évaluation médicale, centre hospitalier Annecy-Genevois, 1, avenue de l'Hôpital, 74370 Pringy, France.
| | - J Fauconnier
- TIMC-IMAG, université Joseph-Fourier, CHU de Grenoble, 38041 Saint-Martin-d'Hères, France
| | - L Jorgensen
- Via Research, LLC, Princeton Junction, NJ, 08550, USA
| | - E M Gutterman
- Via Research, LLC, Princeton Junction, NJ, 08550, USA
| | - S Gray
- Pfizer Inc, Collegeville, PA, 19426, USA
| | - S Munson
- Pfizer Inc, Collegeville, PA, 19426, USA
| | - N Dartois
- Pfizer Europe, 75668 Paris cedex 14, France
| | - J Gaillat
- Service d'information et d'évaluation médicale, centre hospitalier Annecy-Genevois, 1, avenue de l'Hôpital, 74370 Pringy, France
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Escudier E, Pagani L, Gaillat J, Sirodot M, Levrat A. Discussion autour d’un cas mortel de pneumonie nécrosante à Staphylococcus aureus sécrétant la leucocidine de Panton-Valentine. Réanimation 2015. [DOI: 10.1007/s13546-015-1124-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Roubaud Baudron C, Forestier E, Fraisse T, Gaillat J, Bernard L, Pagani L, Gavazzi G, Paccalin M. O-046: Tolerance of subcutaneously administered antibiotics: a national, prospective and observational study. Eur Geriatr Med 2015. [DOI: 10.1016/s1878-7649(15)30059-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Johnson RW, Alvarez-Pasquin MJ, Bijl M, Franco E, Gaillat J, Clara JG, Labetoulle M, Michel JP, Naldi L, Sanmarti LS, Weinke T. Herpes zoster epidemiology, management, and disease and economic burden in Europe: a multidisciplinary perspective. Ther Adv Vaccines 2015; 3:109-20. [PMID: 26478818 PMCID: PMC4591524 DOI: 10.1177/2051013615599151] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Herpes zoster (HZ) is primarily a disease of nerve tissue but the acute and longer-term manifestations require multidisciplinary knowledge and involvement in their management. Complications may be dermatological (e.g. secondary bacterial infection), neurological (e.g. long-term pain, segmental paresis, stroke), ophthalmological (e.g. keratitis, iridocyclitis, secondary glaucoma) or visceral (e.g. pneumonia, hepatitis). The age-related increased incidence of HZ and its complications is thought to be a result of the decline in cell-mediated immunity (immunosenescence), higher incidence of comorbidities with age and social-environmental changes. Individuals who are immunocompromised as a result of disease or therapy are also at increased risk, independent of age. HZ and its complications (particularly postherpetic neuralgia) create a significant burden for the patient, carers, healthcare systems and employers. Prevention and treatment of HZ complications remain a therapeutic challenge despite recent advances. This is an overview of the multidisciplinary implications and management of HZ in which the potential contribution of vaccination to reducing the incidence HZ and its complications are also discussed.
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Affiliation(s)
- Robert W. Johnson
- Senior Research Fellow, Clinical Sciences, University of Bristol, 9 Ridgeway Road, Long Ashton, Bristol, BS41 9EX, UK
| | | | - Marc Bijl
- Department of Internal Medicine and Rheumatology, Martini Hospital, Groningen, The Netherlands
| | - Elisabetta Franco
- Department of Biomedicine and Prevention, University Tor Vergata, Rome, Italy
| | - Jacques Gaillat
- Annecy-Genevois Hospital, Infectious Diseases Department, Annecy, France
| | - João G. Clara
- Lisbon Faculty of Medicine, Lisbon University, Lisbon, Portugal
| | - Marc Labetoulle
- Service d’Ophtalmologie, Hôpital Bicêtre, APHP, Université Paris-Sud, France Département de Virologie, Institute for Integrative Biology of the Cell (I2BC), CNRS, Gif/Yvette, France
| | - Jean-Pierre Michel
- Department of Geriatrics, University Hospitals of Geneva, Belle Idée, Geneva, Switzerland
| | - Luigi Naldi
- Department of Dermatology, Azienda Ospedaliera papa Giovanni XXIII, Bergamo, Italy
| | | | - Thomas Weinke
- Klinikum Ernst von Bergmann, Klinik für Gastroenterologie und Infekiologie, Potsdam, Germany
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Forestier E, Paccalin M, Roubaud-Baudron C, Fraisse T, Gavazzi G, Gaillat J. Subcutaneously administered antibiotics: a national survey of current practice from the French Infectious Diseases (SPILF) and Geriatric Medicine (SFGG) society networks. Clin Microbiol Infect 2014; 21:370.e1-3. [PMID: 25658521 DOI: 10.1016/j.cmi.2014.11.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 11/06/2014] [Accepted: 11/15/2014] [Indexed: 11/28/2022]
Abstract
A national survey was performed to explore antibiotic prescription by the subcutaneous (sc) route among French infectious diseases and geriatric practitioners. Among the participating physicians, 367 (96.1%) declared administering sc antibiotics at some point. Ceftriaxone was prescribed sc by all but one, and ertapenem, teicoplanin, aminoglycosides and amoxicillin by 33.2%, 39.2%, 35.1% and 15.3%, respectively. The sc route was resorted to mainly in case of unavailable oral, intravenous or intramuscular routes, especially during palliative care. Pain, skin necrosis and lack of efficacy were the main adverse effects, reported by 70.8%, 12.8% and 19.9% of practitioners, respectively. Further studies are needed to precise the indications, modalities and tolerance of sc antibiotic use.
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Affiliation(s)
- E Forestier
- Service de Maladies Infectieuses, Centre Hospitalier, Chambéry, France.
| | - M Paccalin
- Service de Gériatrie, Centre Hospitalier Universitaire, Poitiers, France
| | - C Roubaud-Baudron
- Pole de Gérontologie clinique, Centre Hospitalier Universitaire, Bordeaux, France
| | - T Fraisse
- Service de Gériatrie, Centre Hospitalier, Alès, France
| | - G Gavazzi
- Service de Gériatrie, Centre Hospitalier Universitaire, Grenoble, France
| | - J Gaillat
- Service de Maladies Infectieuses, Centre Hospitalier, Annecy, France
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Duracinsky M, Paccalin M, Gavazzi G, El Kebir S, Gaillat J, Strady C, Bouhassira D, Chassany O. ARIZONA study: is the risk of post-herpetic neuralgia and its burden increased in the most elderly patients? BMC Infect Dis 2014; 14:529. [PMID: 25273329 PMCID: PMC4261572 DOI: 10.1186/1471-2334-14-529] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 09/16/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In a context of change in the demographic profile of the older population, to identify an age threshold for increased risk and burden of herpes zoster (HZ) in 70+ patients. METHODS Post hoc analysis of the 12-month French nationwide prospective observational ARIZONA cohort study. HZ was assessed by means of the following validated questionnaires: Neuropathic Pain Symptom Inventory (NPSI), Zoster Brief Pain Inventory (ZBPI), Short-Form health survey (SF-12), and Hospital Anxiety and Depression Scale (HADS). RESULTS 644 general practitioners included 1,358 volunteer patients with acute HZ in the ARIZONA study; 609 patients (45%) were 70+. In 70+ patients, age did not increase rash severity or HZ-related pain intensity at diagnosis, but increased by 64% the frequency of ophthalmic zoster (from 5.5% in 70-74 years age-group to 9.0% in 85+ patients, p = NS). Age was significantly associated with low physical health as assessed by the SF-12 Physical Component Summary (SF-12 PCS) score and bad mood as assessed by the HADS depression score (p < 0.001). Within the year following HZ, post-herpetic neuralgia (PHN) was systematically but not significantly more frequent in 85+ patients than in the 70-74, 75-79, or 80-84 years age-groups (19.0% vs. 13.3%/15.3%/11.6% at month 3; 15.1% vs. 7.3%/11.0%/12.2% at month 6; 15.2% vs. 6.0%/8.0%/6.0% at month12, respectively). SF-12 PCS and HADS depression scores improved from day 0 to month 12 in all patients (p < 0.001). 85+ patients were more impaired than younger patients (p < 0.001), but without clear difference according to PHN. CONCLUSIONS This study did not show in 70+ patients a clear and significant age threshold at which disease burden increased, although for some domains the impact seemed higher among the oldest patients; the cut-off of 70 years remains thus relevant for clinical and epidemiological studies. However, at individual level, assessment of the burden of HZ and HZ-related pain appears necessary to improve management and prevent functional decline in the most vulnerable 70+ patients.
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Affiliation(s)
- Martin Duracinsky
- Paris-Diderot University Sorbonne Paris Cité, EA 7334 REMES, Patient-Reported Outcomes Unit, 75010 Paris, France.
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Fraisse T, Gras Aygon C, Paccalin M, Vitrat V, De Wazieres B, Baudoux V, Lechiche C, Vicens A, Sotto A, Pagani L, Gaillat J, Forestier E, Gavazzi G. Aminoglycosides use in patients over 75 years old. Age Ageing 2014; 43:676-81. [PMID: 24590569 DOI: 10.1093/ageing/afu023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE to describe aminoglycoside use and nephrotoxicity in patients older than 75 years. DESIGN retrospective multicenter study. SETTING hospital department, rehabilitation, long-term care center. POPULATION patients ≥75 years old treated by aminoglycosides. RESULTS 184 patients, mean age: 84.4 years (range: 75-101). One hundred and twenty-seven patients received other nephrotoxic drug(s). Gentamicin (70%) and amikacin (30%) were used and the once-daily dosing was preferred (92%). Average treatment period was 2.75 (1-10) days for amikacin and 4.4 (1-30) for gentamicin with average dosage 13.5 and 3.5 mg/kg/day, respectively. The monitoring of maximal plasmatic concentration (Cmax) was done in 37 patients, 9 of them had probabilistic treatment. Only one had a Cmax fulfilling the objective of French recommendations (gentamicin >30 mg/l, amikacin >60 mg/l). When infection was documented, the objective of Cmax >10 × minimal inhibitory concentration of the strain was reached for 27%. Minimal plasmatic concentration was checked in 38% of cases, with adequate value (gentamicin <0.5 mg/l, amikacin <2.5 mg/l) for 37%. At the end of aminoglycoside course, 40 patients increased their serum creatinine >25% of the baseline value. In multivariate analysis, this was associated with treatment length ≥3 days and concomitant use of nephrotoxic drugs. CONCLUSION aminoglycosides dosing used in elderly patients probably need therapeutic drug monitoring and dose adjustment. Aminoglycosides are used to treat severe infections. One of the most important side effects is nephrotoxicity in oldest patients. To minimise nephrotoxicity, short treatments are necessary and avoiding others nephrotoxic drugs could be relevant.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Albert Sotto
- CHU Caremeau - Infectious Disease, Nimes, France
| | | | | | | | - Gaëtan Gavazzi
- University Hospital of Grenoble - University Clinic of Geriatric Medicine, BP 217, Grenoble 38043, France
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Vitrat V, Piet E, Tolsma V, Bonnin P, Bland S, Chirpaz JM, Gaillat J. G-03: Connaître son écologie dans l’infection osseuse sur matériel, un bon moyen de préserver les antibiotiques ? Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70172-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Gaillat J, Ploy MC, Pelloux I, Lanotte P, Maulin L, Varon E, Lepoutre A. E-13: Épidémiologie des infections invasives à pneumocoque de l’adulte, phase pilote du réseau SIIP. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Forestier E, Paccalin M, Roubaud C, Fraisse T, Gavazzi G, Gaillat J. M-10: Administration des antibiotiques par voie sous-cutanée : pratiques rapportées par les infectiologues et les gériatres français. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70247-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Casez P, Fauconnier J, Munson S, Gray S, Gaillat J. Apport du programme de médicalisation des systèmes d’information pour mesurer l’impact des infections invasives à pneumocoque. Rev Epidemiol Sante Publique 2014. [DOI: 10.1016/j.respe.2014.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Weil-Olivier C, Gaillat J. Can the success of pneumococcal conjugate vaccines for the prevention of pneumococcal diseases in children be extrapolated to adults? Vaccine 2014; 32:2022-6. [PMID: 24565755 DOI: 10.1016/j.vaccine.2014.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/13/2013] [Accepted: 02/06/2014] [Indexed: 11/26/2022]
Abstract
Before conjugate pneumococcal vaccines (PCVs) were introduced it was estimated that Streptococcus pneumoniae caused 500,000 cases of pneumonia, 50,000 cases of bacteremia and 3000 cases of meningitis annually in the United States in both children and adults. After 10 years of routine use of the 7-valent pneumococcal conjugate vaccine (PCV7) the incidence of vaccine-type pneumococcal diseases (PDs) had significantly decreased in vaccinated children (direct effect) and unvaccinated subjects of all ages (indirect effect). Second generation, higher-valent PCVs, especially 13-valent (PCV13), routinely implemented since 2010, have reduced the incidence of PDs caused by the six additional non-PCV7 serotypes, in both vaccinated and unvaccinated subjects. The licence for this vaccine has recently been extended to include adults aged 18 to 49 in Europe. Although PCV13 has an indirect effect on IPD in adults, this will probably not achieve the same level of disease control in adults and the elderly (especially those at high risk) as that obtained in vaccinated children. As highlighted in this paper, differences exist between children and adults for PD manifestations (incidence, morbidity and mortality) and serotypes isolated in nasopharyngeal carriage and diseases, so benefits from adult vaccination must be considered in this light. PCV13 induces an immune response in adults that is non-inferior for all serotypes common with the 23-valent plain polysaccharide vaccine that is currently recommended for adults and even superior for many serotypes. Although there is no evidence that this immune response translates to clinical efficacy in adults as seen in children, the results from a randomised trial in The Netherlands, expected in 2014, should provide the missing evidence. This evidence and efficient surveillance systems should provide the necessary data, essential for policy makers in their decisions on adult pneumococcal vaccination policies.
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Affiliation(s)
- Catherine Weil-Olivier
- Department of Pediatrics, University Denis Diderot, 5 Rue Thomas Mann, 75013 Paris, France.
| | - Jacques Gaillat
- Department of Infectious Diseases, CH Annecy, 1 Avenue de l'Hôpital, Metz-Tessy BP 90074, 74374 Pringy Cedex, France.
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Chidiac C, Laurichesse H, Illes G, Gaillat J, Bonnin P, Ricard JD, Messika J, Detournay B, Saba G, Petitpretz P, De Pouvourville G. 777Cost of Treating Patients with Pneumococcal Community-Acquired Pneumonia (CAP) in French Hospitals: Interim Results of the Prospective PNEUMOCOST Study. Open Forum Infect Dis 2014. [DOI: 10.1093/ofid/ofu052.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rouveix E, Greffe S, Dupont C, Gherissi Cherni D, Beauchet A, Sordet Guepet H, Gavazzi G, Gaillat J. Faible taux de couverture vaccinale contre la grippe des sujets âgés hospitalisés en France. Rev Med Interne 2013; 34:730-4. [DOI: 10.1016/j.revmed.2013.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 12/24/2012] [Accepted: 02/02/2013] [Indexed: 10/27/2022]
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Rabaud C, Rogeaux O, Launay O, Strady C, Mann C, Chassany O, Bouhassira D, Gaillat J. Early antiviral treatment fails to completely prevent herpes-related pain. Med Mal Infect 2013; 43:461-6. [DOI: 10.1016/j.medmal.2013.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 07/17/2013] [Accepted: 07/25/2013] [Indexed: 11/16/2022]
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Jéru I, Charmion S, Cochet E, Copin B, Le Borgne G, Cathebras P, Gaillat J, Duquesnoy P, Karabina S, Hentgen V, Amselem S. P02-014 - Consequences of Arginine 92 mutations in TNFR1. Pediatr Rheumatol Online J 2013. [PMCID: PMC3953032 DOI: 10.1186/1546-0096-11-s1-a121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Gavazzi G, Delerce E, Cambau E, Francois P, Corroyer B, de Wazières B, Fougère B, Paccalin M, Gaillat J. Diagnostic criteria for urinary tract infection in hospitalized elderly patients over 75 years of age: A multicenter cross-sectional study. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Fraisse T, Gras Aygoin C, de Wazieres B, Paccalin M, Vitrat V, Forestier E, Gaillat J, Gavazzi G. Aminoglycosides use in elderly population: A retrospective observational study in 38 centers in France. Eur Geriatr Med 2013. [DOI: 10.1016/j.eurger.2013.07.397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jéru I, Charmion S, Cochet E, Copin B, Duquesnoy P, Garcia MTM, Le Borgne G, Cathebras P, Gaillat J, Karabina S, Dodé C, Lohse P, Hentgen V, Amselem S. Involvement of the same TNFR1 residue in mendelian and multifactorial inflammatory disorders. PLoS One 2013; 8:e69757. [PMID: 23894535 PMCID: PMC3722142 DOI: 10.1371/journal.pone.0069757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 06/11/2013] [Indexed: 11/19/2022] Open
Abstract
Objectives TNFRSF1A is involved in an autosomal dominant autoinflammatory disorder called TNFR-associated periodic syndrome (TRAPS). Most TNFRSF1A mutations are missense changes and, apart from those affecting conserved cysteines, their deleterious effect remains often questionable. This is especially true for the frequent R92Q mutation, which might not be responsible for TRAPS per se but represents a susceptibility factor to multifactorial inflammatory disorders. This study investigates TRAPS pathophysiology in a family exceptional by its size (13 members) and compares the consequences of several mutations affecting arginine 92. Methods TNFRSF1A screening was performed by PCR-sequencing. Comparison of the 3-dimensional structure and electrostatic properties of wild-type and mutated TNFR1 proteins was performed by in silico homology modeling. TNFR1 expression was assessed by FACS analysis, western blotting and ELISA in lysates and supernatants of HEK293T cells transiently expressing wild-type and mutated TNFR1. Results A TNFRSF1A heterozygous missense mutation, R92W (c.361C>T), was shown to perfectly segregate with typical TRAPS manifestations within the family investigated (p<5.10−4). It was associated with very high disease penetrance (0.9). Prediction of its impact on the protein structure revealed local conformational changes and alterations of the receptor electrostatic properties. R92W also impairs the TNFR1 expression at the cell surface and the levels of soluble receptor. Similar results were obtained with R92P, another mutation previously identified in a very small familial form with incomplete penetrance and variable expressivity. In contrast, TNFR1-R92Q behaves like the wild-type receptor. Conclusions These data demonstrate the pathogenicity of a mutation affecting arginine 92, a residue whose involvement in inflammatory disorders is deeply debated. Combined with previous reports on arginine 92 mutations, this study discloses an unusual situation in which different amino acid substitutions at the same position in the protein are associated with a clinical spectrum bridging Mendelian to multifactorial conditions.
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Affiliation(s)
- Isabelle Jéru
- UMR_S933, Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France.
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